• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.99-106
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• 2017

Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10129-10135
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• 2015

Background: Tobacco is a leading preventable cause of deaths worldwide; the situation is particularly serious in the developing countries. Tobacco use amongst the children and adolescents is already a pandemic and they are vulnerable targets of tobacco industry. This is also the case in India. Objectives: 1) Document and monitor the prevalence of tobacco use including smoked, smokeless and other forms of tobacco; 2) Understand student knowledge and attitudes related to tobacco use and its health impact; 3) Assess the impact of tobacco on the oral health status of school-going children in India. Materials and Methods: The sample was 1,500 school children of the age group 12-15 years age. A pretested, close ended questionnaire was administered in the form of extensive face to face interview to understand student knowledge, attitudes and behavior related to tobacco use and its health impact and to assess the prevalence of tobacco use including smoked, smokeless and other forms of tobacco. Oral health status was assessed using the Community Periodontal Index (CPI). Frequency distribution, Chi-square tests and Odd's ratio was calculated. Results: Prevalence of tobacco usage amongst the prevalence was 20.4%: 9.2% reported smoking, 15.8% used tobacco in the chewable form and 25.3% children were involved in consuming betel nut/areca nuts. The OR (Odd's ratio) for calculus formation was highest for guthka chewers (OR=14.322), paan masala chewers had the highest odds of developing bleeding on probing when compared to the others. Conclusions: There is an urgent need to launch school-based tobacco prevention programs for community awareness of children and the public, as preventing the initiation of a habit is far easier than stopping it.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.57-64
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• 2016

Background: Tobacco smoking is considered a risk factor for cervical cancer development due to the presence of tobacco based carcinogenic metabolites in cervical cells of female smokers. In this study, we investigated the role of the T3801C (MspI) polymorphism of CYP1A1, a gene encoding an enzyme necessary for the initiation of tobacco based carcinogen metabolism, on cervical cancer risk. The T to C substitution may alter CYP1A1 activities, potentially elevating cervical cancer risk. Since results of gene-disease association studies vary according to the study population, the multi-ethnic population of Malaysia provides an excellent representative cohort for identifying and comparing the cervical cancer risk among the 3 major ethnics in Southeast Asia in relation to CYP1A1 MspI polymorphism. Materials and Methods: A total of 195 Thin Prep Pap smear samples from HPV negative and cancer free females were randomly selected as controls while 106 formalin fixed paraffin embedded samples from females with invasive cervical cancer were randomly selected for the cases group. The polymorphisms were identified using restriction fragment length polymorphism (RFLP) PCR. Results: We found no significant associations between CYP1A1 MspI polymorphism and cervical cancer in the general Malaysian female population. However, upon ethnic stratification, the variant C/C genotype was significantly associated with a 4.66-fold increase in cervical cancer risk in Malay females (95% CI= 1.21-17.9; p=0.03). No significant association was observed in the Chinese and Indian females. Additionally, there were no significant associations in the dominant model and allele frequency model analysis in both the general and ethnically stratified female population of Malaysia. Conclusions: Our findings suggest that the C/C genotype of CYP1A1 MspI polymorphism is associated with the development of cervical carcinoma in the Malay females of Malaysia.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.96-104
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• 2021

Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥50%, post-bronchodilator FEV₁/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV₁ at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV₁ versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

• Journal of Nutrition and Health
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• v.42 no.5
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• pp.442-452
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• 2009

Smoking has been known to exacerbate the initiation and propagation of oxidative stresses. Efforts have been made to reduce the smoking-induced oxidative stresses using commercial dietary supplements. Propolis is the resinous substance collected by bees from the leaf buds and bark of trees, especially poplar and conifer trees. In this trial, we examined whether a daily supplementation of 800 mg propolis can protect endogenous lymphocytic DNA damage and modulate antioxidative enzyme activities and the level of antioxidant vitamin in smokers using a placebo-controlled, doubleblinded cross-over trial. After two weeks of running-in period, 29 smokers (mean age 34.38 ${\pm}$ 1.73) received 6 tablets/day of either propolis or placebo pills for 4 weeks. After 2 weeks of washout period the subjects switched they pills for cross-over study. The degree of DNA damage (assessed by tail DNA, tail length and tail moment) was not significantly changed with propolis intake or placebo intake. Similarly, total antioxidant status (TAS) remained at the same level regardless of the treatment. Erythrocyte catalase, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), plasma vitamin C and tocopherol level did not differ before and after propolis treatment, and did not differ between treatments. Putting all these results together, we would suggest that it is still too early to claim that propolis possess antioxidative activities.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.324-337
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• 1990

To assess the effectiveness of the interventions in working environment and personal hygiene for the occupational exposure to the lead, 156 workers (116 exposed subjects and 40 controls) of a newly established battery factory were examined for their blood lead concentration (Pb-B) in every 3 months up to 18 months. Air lead concentration (Pb-A) of the workplaces was also checked for 3 times in 6 months interval from August 1987. Environmental intervention included the local exhaust ventilation and vacuum cleaning of the floor. Intervention of the personal hygiene included the daily change of clothes, compulsory shower after work and hand washing before meal, prohibition of cigarette smoking and food consumption at the work site and wearing mask. Mean Pb-B of the controls was $21.97{\pm}3.36{\mu}g/dl$ at the preemployment examination and slightly increased to $22.75{\pm}3.38{\mu}g/dl$ after 6 months. Mean Pb-B of the workers who were employed before the factory was in operation (Group A) was $20.49{\pm}3.84{\mu}g/dl$ on employment and it was increased to $23.90{\pm}5.30{\mu}g/dl$ after 3 months (p<0.01). Pb-B was increased to $28.84{\pm}5.76{\mu}g/dl$ 6 months after the employment which was 1 month after the initiation of intervention program. It did not increase thereafter and ranged between $26.83{\mu}g/dl\;and\;28.28{\mu}g/dl$ in the subsequent 4 tests. Mean Pb-B of the workers who were employed after the factory had been in operation but before the intervention program was initiated (Group B) was $16.58{\pm}4/53{\mu}g/dl$ before the exposure and it was increased to $28.82{\pm}5.66{\mu}g/dl$(P<0.01) in 3 months later (1 month after the intervention). The values of subsequent 4 tests remained between 26.46 and $28.54{\mu}g/dl$. Mean Pb-B of the workers who were employed after intervention program had been started (Group C) was $19.45{\pm}3.44{\mu}g/dl$ at the preemployment examination and gradually increased to $22.70{\pm}4.55{\mu}g/dl$ after 3 months(P<0.01), $23.68{\pm}4.18{\mu}g/dl$ after 6 months, and $24.42{\pm}3.60{\mu}g/dl$ after 9 months. Work stations were classified into 4 parts according to Pb-A. The Pb-A of part I, the highest areas, were $0.365mg/m^3$, and after the intervention the levels were decreased to $0.216mg/m^3\;and\;0.208mg/m^3$ in follow-up tests. The Pb-A of part II was decreased from $0.232mg/m^3\;to\;0.148mg/m^3,\;and\;0.120mg/m^3$ after the intervention. Pb-A of part III and W was tested only after intervention and the Pb-A of part III were $0.124mg/m^3$ in Jannuary 1988 and $0.081mg/m^3$ in August 1988. The Pb-A of part IV not stationed at one place but moving around, was $0.110mg/m^3$ in August 1988. There was no consistent relationship between Pb-B and Pb-A. Pb-B of the group A and B workers in the part of the highest Pb-A were lower than those of the workers in the parts of lower Pb-A. Pb-B of the workers in the part of the lowest Pb-A incerased more rapidly. Pb-B of group C workers was the highest in part I and the lowest in part IV. These findings suggest that Pb-B is more valid method than Pb-A for monitoring the health of lead workers and intervention in personal hygiene is more effective than environmental intervention.

• Journal of Preventive Medicine and Public Health
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• v.31 no.1 s.60
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• pp.112-126
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• 1998

To investigate the effectiveness of the interventions in working environment and personal hygiene for the occupational exposure to the lead, the blood zinc protoporphyrin (ZPP) concentrations of 131 workers (100 exposed subjects and 31 controls) of a newly established battery factory were analyzed. They were measured in every 3 months up to 18 months. Ai. lead concentration (Pb-A) of the workplaces was also checked for 3 times in 6 months interval from August 1987. Environmental intervention included the local exhaust ventilation and vacuum cleaning of the floor. Intervention of the personal hygiene included the daily change of clothes, compulsory shower after work and hand washing before meal, prohibition of cigarette smoking and food consumption at the work site and wearing mask. Mean blood ZPP concentration of the controls was $16.45{\pm}4.83{\mu}g/d\ell$ at the preemployment examination and slightly increased to $17.77{\pm}5.59{\mu}g/d\ell$ after 6 months. Mean blood ZPP concentration of the exposed subjects who were employed before the factory was in operation (Group A) was $17.36{\pm}5.20{\mu}g/d\ell$ on employment and it was increased to $23.00{\pm}13.06{\mu}g/d\ell$ after 3 months. The blood ZPP concentration was increased to $27.25{\pm}6.40{\mu}g/d\ell$ on 6 months (p<0.01) after the employment which was 1 month after the initiation of intervention program. It did not increase thereafter and ranged between $25.48{\mu}g/d\ell$ and $26.61{\mu}g/d\ell$ in the subsequent 4 results. Mean blood ZPP concentration of the exposed subjects who were employed after the factory had been in operation but before the intervention program was initiated (Group B) was $14.34{\pm}6.10{\mu}g/d\ell$ on employment and it was increased to $28.97{\pm}7.14{\mu}g/d\ell$ (p<0.01) in 3 months later(1 month after the intervention). The values of subsequent 4 tests were maintained between $26.96{\mu}g/d\ell$and $27.96{\mu}g/d\ell$. Mean blood ZPP concentration of the exposed subjects who were employed after intervention program had been started (Group C) was$21.34{\pm}5.25{\mu}g/d\ell$ on employment and it was gradually increased to $23.37{\pm}3.86{\mu}g/d\ell$ (p<0.01) after 3 months, $23.93{\pm}3.64{\mu}g/d\ell$ after 6 months, $25.50{\pm}3.01{\mu}g/d\ell$ after 9 months, and $25.50{\pm}3.10{\mu}g/d\ell$ after 12 months. Workplaces were classified into 4 parts according to Pb-A. The Pb-A of part I, the highest areas, were $0.365mg/m^3$, and after the intervention the levels were decreased to $0.216mg/m^3$ and$0.208mg/m^3$ in follow-up test. The Pb-A of part II which was resulted in lowe. value than part I was decreased from $0.232mg/m^3$ to $0.148mg/m^3$, and $0.120mg/m^3$ after the intervention. The Pb-A of part III was tested after the intervention and resulted in $0.124mg/m^3$ in January 1988 and $0.181mg/m^3$ in August 1988. The Pb-A of part IV was also tested after the intervention and resulted in $0.110mg/m^3$ in August 1988. There was no consistent relationship between Pb-A and blood ZPP concentration. The blood ZPP concentration of the group A and B workers in the part of the highest Pb-A were lower than those of the workers in the parts of lower Pb-A. The blood ZPP concentration of the workers in the part of the lowest Pb-A increased more rapidly. The blood ZPP concentration of the group C workers was the highest in part III. These findings suggest that the intervention in personal hygiene is more effective than environmental intervention, and it should be carried out from the first day of employment and to both the exposed subjects, blue color workers and the controls, white color workers.